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over prescribing of oral apperients

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Author over prescribing of oral apperients

mike

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mike

  • Joined: Aug 2005
  • Location: SA
  • Posts: 5

Wed Aug 17, 2005 10:08 pm

I have noticed that older patients tend to all have oral apperients as a regular order, doesn't this encourage dependance on these apperients? i have found that they then tend to progressively need more stronger or invasive treatment eg: suppositorys, enemas, as this dependance develops. what does everyone think ?

Neil

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Neil
  • Joined: Jun 2005
  • Location: Balmain
  • Posts: 11

Aug 18, 2005, 05:27 am

Mike,

I think you will find that some of the problem is that the elderly have been obsessed with their bowels for years and taken loads of different medications that they already have the dependence there when they come into hospital , and thats when we also discover that they don't drink enough and get constipated, so they need something again, unless we are able to educate them about diet and fluids things will not change.

 

Neil

kerry

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kerry
  • Joined: Jun 2005
  • Location:
  • Posts: 13

Aug 18, 2005, 11:45 am

I agree with Neil, patients need more education as to how bowels actually work.  A sedentry life and not drinking enough water is going to contribute to 'bowels not working', and this is what many older people are doing in hospital, on top of whatever other illness they have.  I have tried to get people up a moving around, but many have knee problens, previous falls etc. and don't want to.  Also I have had patients who don't drink water because they know they will have to get up eventually to go to the toilet and would prefer not to.  What do you think??

mike

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mike
  • Joined: Aug 2005
  • Location: SA
  • Posts: 5

Aug 18, 2005, 05:03 pm Last edited Aug 18, 2005, 05:03 pm update #1

Those factors are definately a major part of the problem, i agree that they as a whole don't drink enough fluids and their decreased mobility contributes to the problem. i just think that there should be more emphasis on increasing mobility and fluid intake to help manage the bowels as well as education as you mentioned. a more holistic approach.

modified: Friday 19 August 2005 10:15:23 pm - mike

chajo

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  • Joined: Aug 2005
  • Location: Brisbane
  • Posts: 6

Jul 01, 2006, 11:24 am

I agree- elders have traditionally taken "salts" or similar just in case. It amazes me the number of people admitted to our facility who list 2 or 3 different aperients as regular medication. It stems from the belief if that one did not "go" everyday there was something wrong. Education goes part way but we need to be creative in how we boost our resident's fluid intake- jellies. Bonox, regular fluid rounds- we have recently introduced ice blocks ( not ice cream) as an extra and it has been a hit - especially in the Queensland summer. Consider serving chilled water with a dash of lemon, orange or lime in a carafe on the dining table- dress it up with a sprig of mint- these visually pleasing tactics tweak the curiosity and I have seen residents who believe that water is for "washing only!" drink a full glass of water and come back for a second. We need to focus on the culture our present residents came from and capitalise on it

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